While some Indian Tribes have low morbidity and mortality rates from cancer, Northern Plains Indians, including the Sioux, have higher rates than the U.S. population in general. The purpose of this research is to assess the burden of cancer in the Sioux Indians, and to define the prevalence and population attributable risk of risk factors that contribute to the high rates of cancer using the following methodology: 1) Age and sex-specific cancer mortality rates and trends to be determined from death certificate data for all Sioux tribes in conjunction with a national review of IHS cancer mortality data. 2) The adequacy, acceptability and utility of cancer screening will be determine. 3) Cancer risk factor prevalence to be determined by interview and examination. 4) Population attributable risk for cancer risk factors in Sioux Indians to be determined using a case-control methodology. 5) The reasons for the high prevalence of smoking will be investigated by a questionnaire. Participants will include 1500 Sioux residents aged 45 and over of selected communities on 3 reservations in the Dakotas. All participants will receive health risk appraisals informing them how to improve their health. Health problems detected through the research will be referred for appropriate treatment. The long-term goal will be to implement community-based programs to reduce cancer risk factors throughout the Aberdeen Area.